An integrated mind-body approach to arthritis: A pilot study (original) (raw)
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Chronic pain (CP) and rheumatoid arthritis (RA) pose a particular challenge for the individual. While biomedicine inevitably plays a role in the reduction or control of some symptoms for people living with chronic pain, directed self-management is also increasingly recognized as an important tool. Self-management can address pain associated symptoms of CP and RA and often has broader aims, such as promoting positive well-being. Forty-six interviews with people experiencing CP and 46 interviews with those living with RA associated pain were analysed. Our analysis uncovered three broad strategies adopted by participants: body management, mind management and mind-body management. The analysis demonstrated that for those living with pain, a sense of well-being is achieved not through pain control alone, but also through various mind/body techniques for managing pain, accepting new limits, and adjusting the way people relate to themselves. These self management strategies are an important adjunct to biomedical care for those experiencing chronic pain.
Mind and body management strategies for chronic pain and rheumatoid arthritis
2009
Abstract Chronic pain (CP) and rheumatoid arthritis (RA) pose particular challenges for the individual. Although biomedicine inevitably plays a role in the reduction or control of some symptoms for people living with chronic pain, directed self-management is also increasingly recognized as an important tool. Self-management can address pain-associated symptoms of CP and RA, and often has broader aims, such as promoting positive well-being.
Journal of Clinical Medicine, 2021
Biopsychosocial intervention has been suggested as a complementary treatment strategy for patients with chronic conditions. We compared the effect of a mind–body intervention (MBI), relative to treatment-as-usual (TAU) on WHO-5 Well-being Index during an intensive period of 12 weeks and follow-up at week 26 among patients with either psoriasis (PsO) or rheumatoid arthritis (RA). The MBI was based on the ‘Relaxation Response Resiliency Program’ and the ‘Open and Calm Program’, as well as ‘Mindfulness Based Stress Reduction’ (MBSR). The trial was randomized, management-as-usual, and controlled. Statistical analyses were based on the intention-to-treat population using repeated measures and mixed effects models (NCT03888261). We screened 39 potential participants, 35 of which (PsO, n = 20; RA, n = 15) met the eligibility criteria and were randomized: 17 in the MBI group and 18 in the TAU group. Attrition from the intervention program was 19%, with 65% of MBI patients and 71% of TAU pat...
Rheumatoid Arthritis: A cognitive-behavioural intervention (Thesis, 1991)
This study investigated both the mediating role of psychological adjustment in determining pain experience, disease status, and immune function in Rheumatoid Arthritis (RA), and the value of cognitive-behavioural intervention in improving the overall health status of such patients. Two related hypotheses were tested in a matched-random assigned two-groups design, with pre-, mid-, and post-intervention assessment. Fourteen (N= 14) female RA out- patients, selected along established inclusion criteria, were allocated to either treatment (n=8) or control (n=6) groups after being matched on date of disease onset and ratings, of coping efficacy. The treatment group received an eight week Stress Inoculation and Pain Management Training programme (sixteen 2-hour sessions) based on the conceptual approach of Meichenbaum (1985) and adopted from a program by O'Leary, Shoor, Lorig and Holman (1988). The program included educational material, instruction in palliative and cognitive pain management strategies and the application thereof in daily living, goal setting to improve activity function, and group discussion. The program was designed to nurture and develop existing coping skills, and to impart new strategies to cope with daily stress and pain. Pre-intervention correlational analyses tested the extent to which mood disturbance, self-perceptions of coping efficacy, health locus of control and stressful life experience were related to intensity and quality of pain, disease activity, functional status and lymphocyte proliferation rate. Intra- and inter-group analyses were conducted to determine treatment effects in terms of change scores on the dependent measures, and case studies were conducted to evaluate individual response both to disease and cognitive-behavioural intervention. RA was characterized more by poor psychological health status than physical disability. Such patients showing marked mood disturbance and poor perceptions of coping efficacy. Pain was found to be more a function of psychological adjustment than actual disease status, with the meaning of the pain, and the accompanying mood disturbance being the most salient factors of the pain experience. Lymphocyte proliferation rate was normal, and unrelated to disease or psychological variables. No significant treatment effects were found at intra- or inter-group levels of analysis. Case studies indicated the complex nature of the individual disease state, and the RA patient's response to psychological intervention. The value of cognitive-behavioural intervention in RA, and implications for future psycho-neuro-immunology (PNI) research in RA are discussed in terms of such findings.